Teenage Acne 101: Complete Guide on How Puberty Affects Skin & Hair

Many teens or pre-teens start getting acne during puberty. In this article, we explain teenage acne forms, and how puberty affects the skin and hair, including excerpts from Acne Care Bible: Dermatologist’s Tips For Acne Treatment & Prevention by Dr. Teo Wan Lin, dermatologist at TWL Specialist Skin & Laser Centre.

We will start from a medical perspective, explaining the changes that occur physiologically that result in the external body changes observed in teenagers as they transition to adulthood. Thereafter, we will cover the specific skin and hair changes caused by puberty, like teenage acne.

Firstly, when does puberty occur? 

Between the ages of 10 to 14, both boys and girls start to secrete sex hormones. 

What happens to the body during puberty?

Puberty is marked by the secretion of sex hormones. For boys, they start to produce the male hormone testosterone whilst for girls, they start to produce both estrogen (which is the feminine hormone) as well as testosterone. In boys, they will observe that their voice may change, as well as growing a more toned and muscular physique, along with genital enlargement. All these are the effects of testosterone. 

Girls will experience breast and nipple enlargement in the early stages of puberty. The onset of puberty in girls is marked by the start of their period or the menstruation cycle. 

The influence of sex hormones on skin

Puberty is determined by the onset of the secretion of sex hormones, the timing of which varies slightly between individuals and may occur in stages over a period of several years. Where the skin is concerned, we shall now zoom in specifically on the influence of sex hormones on overall skin texture, appearance and function.

Did you know that testosterone is responsible for the production of oil? This is the cause of teens developing greasier skin and teenage acne as a result. Sex hormones are chemicals which trigger off the activity of oil glands, which are also known as the sebaceous glands because they produce sebum. Estrogens in females specifically help the skin to attain a smooth and soft appearance. This explains why women, in general, have smoother and softer skin than men.

The same process occurs on one’s scalp as well. The scalp, face, chest and back form an area termed as the “seborrheic areas”, which really refer to areas that produce more oil. During this time, teenagers and young adults may also observe the development of teenage acne or acne-like rashes over the chest and back area. This can be due to acne itself and/or a type of skin rash induced by a fungus.

Colloquially termed as fungal acne, it is a misnomer because this is not true acne. Rather, it is inflammation of the follicles caused by a yeast known as Malessezia Furfur, a condition known as Pityosporum folliculitis. Both are related to the overproduction of oil, increased sweating such as during sports, and is especially common in individuals living in humid climates.

Effects of puberty on skin

If you are experiencing any of these symptoms, know that this is part of adolescence. A lot of hormones are being released into your body during puberty. These actively act on areas such as your scalp, your hair, and skin during your transformation to adulthood. 

What’s happening to my skin? 

1. Greasier skin that cause teenage acne

Have you noticed your skin becoming greasier over your forehead, nose, and chin? Don’t be alarmed! This is a common phenomenon known as T-Zone oiliness. The oil glands are concentrated over these areas. Oil glands are also known as sebaceous glands which are associated with hair follicles. Every area of your body has hair follicles other than your palms and your soles. Seborrheic areas are areas where the hair follicles are associated with oil glands. These would be the T-Zone of the face, the scalp, The central ‘V’ of the chest as well as on the back. 

2. Enlarged pores with blackheads and whiteheads

What you may see as black dots appearing over your nose and chin are actually not “dirt” that you should try to pick and squeeze out, but rather blackheads or open comedones, which are a form of teenage acne. If you observe an increase in the size of the pores of your skin, this is related to the increased activity of the sebaceous glands, which are responsible for producing oil.

What’s happening to my hair? Teenage Acne on the Scalp?
Changes in hair and scalp

If you’ve noticed your scalp getting greasier recently and even experience pimples on the scalp, do not worry, this is part of puberty and teenage acne. The oil glands that are active on your skin are also active on the scalp. They form a primary role of providing lubrication to the hair shaft to facilitate development of thicker, denser luscious hair.

Causes of greasy scalp and dry hair

The hair is made up of three distinct components. You have the roots of the head where the hair is embedded in your scalp; this is where it is associated with the sebaceous glands that produce oil (sebum). The second part of your hair you should know about is the hair shaft. The hair shaft is composed of dead material, this is known as keratin. The part that is “alive” is the follicle growing on your scalp.

Finally, your hair ends. You may have heard about split ends. It is due to damage at the end of the hair shaft, often caused by grooming practices. It is possible to have both greasy scalp and dry hair ends if you are using the wrong types of shampoo. Certain commercial shampoos for dry hair ends are not suitable for individuals with greasy scalps, whilst others cater for oily scalps contain high amounts of drying ingredients (known as astringents) which can cause the hair shaft to be excessively dry. 

Do I have dandruff? What is dandruff?

The teenage years are when one starts to observe changes in the scalp such as scalp flaking. Otherwise known as dandruff, but more accurately, as seborrheic dermatitis in medical terms. Many adult patients recall having their first episodes of having dandruff in teenage years. Dandruff is a layperson term for a medical condition known as seborrheic dermatitis. The term “seborrheic” derives from the root word sebum, referring to oil production. By now you would be familiar with the term seborrhea. Hence it is a condition related to an oily scalp. 

What causes dandruff to form? 

Seborrheic dermatitis is caused by a yeast that grows on everyone’s scalp and skin. That’s right, so even in healthy, young, and old individuals, the yeast is a healthy commensal. The name of this disease is Malassezia furfur. It tends to overgrow in individuals who produce more oil than others and in warm humid climates like Singapore and the tropics. Combined with sweat, this is the optimal environment for the overgrowth of this yeast. Overgrowth of the yeast then leads to inflammation of the skin as well as the scalp.

On the skin, this may appear as whitehead-like bumps that people often mistake for teenage acne. In reality, it is actually fungal acne and is found commonly over the hairline and the jawline. When over the scalp, it develops into dandruff. Specifically, people who suffer from seborrheic dermatitis may also complain of scalp sensitivity as well as discomfort. If you find that your scalp is feeling greasy at the end of every day or when you wake up in the morning, then very likely you produce more oil than normal. 

Are there any individuals who enter into puberty and do not have these symptoms? 

Yes. However, most individuals will observe these changes in their skin including the scalp as they become teenagers, and experience teenage acne. However, the key feature here would be genetics. So if any of your parents had suffered from oily scalp, oily skin and teenage acne when they were teenagers, you will likely have the same symptoms. 

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